2013 NATIONAL PROGRESS REPORT NETWORKS, CONNECTED. AND SAFE-Rx RANKINGS INFORMATION, ACTIVATED. CARE, COORDINATED. 2800 CRYSTAL DRIVE ARLINGTON, VA 22202 WWW.SURESCRIPTS.COM FOLLOW US ON TWITTER AT: TWITTER.COM/SURESCRIPTS Designed by Curran & Connors, Inc. / www.curran-connors.com www.surescripts.com SURESCRIPTS TODAY 2013 National Progress Report and Safe-Rx Rankings Surescripts was founded in 2001 with a mission to eliminate • We know that people and organizations working together, Our purpose is to connect fragmented healthcare into a coherent paper prescriptions and deliver important medical information across silos, will make healthcare more efficient, more effective whole to enable more efficient and effective healthcare. Each TRANSACTIONS electronically. Just as we’ve witnessed continued growth in and easier to navigate. day, our work touches upon a wide range of people, processes ANNUALLY e-prescribing, so too have we seen the complexity of the and products rooted in our three core capabilities: • We believe that healthcare is inextricably linked to technology, healthcare system multiply, while patients and providers demand and if technology improves, healthcare will improve with it. CONNECT: We connect to the broadest community of care easier access to health information. Today, we have the assets partners. Surescripts helps improve care collaboration, saving and the experience that are needed to enable the electronic AS OF THE END OF 2013, SURESCRIPTS CONNECTS: time and resources, by integrating disparate IT systems between exchange of a diverse range of health information. EHR APPLICATIONS • 566,000 prescribers hospitals, physicians, payers, pharmacies, labs and other • We operate the network and build the relationships that • 95% of community pharmacies healthcare stakeholders. enable vital information to flow freely and securely to the right • More than 400 hospitals and IDNs EXCHANGE: We exchange a wide range of information across place at the right time. • More than 70% of physicians networks from a single point of connectivity, facilitating timely • We see American healthcare as a collection of disparate parts, and secure access to the data that is needed in today’s quality- OF PHARMACIES • More than 600 EHR applications each powerful in its own way, but whose collective potential driven and evidenced-based care environment. • 43 state immunization registries has yet to be tapped. • 21 health information exchanges (HIEs) and health information PROTECT: We protect data with rigorous security measures and service providers (HISPs) industry-leading standards to improve security, quality and privacy. THE EVOLUTION OF SURESCRIPTS 2001 2008 2009 2010 2012 2013 • SureScripts founded • SureScripts and • SureScripts-RxHub relaunched • Clinical Messaging and EPCS launched • Prescription Drug • 58% of prescriptions routed electronically RxHub merged as Surescripts Monitoring Program • Electronic Prior Authorization, Medication History (PDMP) and and Immunization Registry Reporting launched Immunization Notifications launched SURESCRIPTS PROGRESS INDUSTRY PROGRESS • American Recovery and Reinvestment Act provided $19 billion to drive health IT adoption • 36% of office-based • 58% of office-based • 69% of office-based • 73% of office-based physicians e-prescribed • CMS released Meaningful Use regulations physicians physicians physicians • EPCS legalized in 48 states • 4% of office-based • E-prescribing legalized in • DEA proposed Electronic • Medicare launched MIPPA e-prescribing e-prescribed e-prescribed e-prescribed physicians all 50 states and D.C. Prescribing of Controlled incentive program • Meaningful Use e-prescribed Substances (EPCS) rule Stage 1 initiated 2004 2007 2008 2009 2010 2011 2012 2013 1 www.surescripts.com 2013 National Progress Report and Safe-Rx Rankings ELECTRONIC PRESCRIBING USE ELECTRONIC PRESCRIBING ADOPTION 800 699M +19% 0 10 20 30 40 50 60 70 80 700 In 2013, more th an 73% of Active Office-based Physicians Pediatricians Lead Growth in E-Prescribing Adoption with 24% Increase 800 E-Prescribed1 600 586M 699M +19% E- PRESCRIBING E- PRESCRIBING YEAR- TO -YEAR 0 10 20 30 40 50 60 70 80 SPECIALTY 700 500 7 out of 10 office-based physicians e-prescribed in 2013, IN 2012 IN 2013 GROWTH a 4% increase in e-prescribing use over 2012. 2011 58% 395M 400 586M 2012 69% 1 Internist 79% 96% +22% 600 Note: The darker the area, the greater the concentration of active 2013 73% e-prescribers. 2 Family Practitioner 71% 85% +20% 300 500 3 Endocrinology & Metabolism 71% 81% +14% 22001111 58% 200 395M 22001122 69% 4 Cardiovascular Disease 72% 80% +11% 400 22001133 73% 100 5 Pediatrician 63% 78% +24% 2011 2012 2013 300 0 200 More than Half of All 19% Continued Growth in Mail-Order Pharmacies Prescriptions Routed Medication Histories Routed 31% More Solo Practitioners Drive Growth in E-Prescribing Adoption 100 Electronically2 Delivered E-Prescriptions Growth 2013 Solo Practitioner 2012 58% (+19%) 2011 2012 2013 2013 69% 0 1200 800 80 2012 64% 1.04 2 to 5 98% (+14%) BILLION +32% 699M +19% 0 10 20 30 40 502013 60 70 80 73% 700 Renewal Rx 70 1000 63M +31% 2012 65% 106M 6 to 10 2013 73% (+12%) New Rx 586M 600 60932M 2011–2013 2012 55% 800 11 to 25 2013 61% (+11%) 500 82M 50 48M 2012 37% 706M 2011 58% 395M 2012 26 to 100 2013 69% 42% (+14%) 600 400 40 2013 73% 1200 58M 2012 34% 1.04 100+ 2013 38% (+12%) 300 474M 30 400 BILLION +32% 25M 200 20 1000 106M Small practices of 25 or fewer physicians continue to lead in e-prescribing adoption and use. 200 All practice sizes except those of 100 or more physicians exceeded 40% adoption. 100 932M 10 2011 2012 2013 2011 2012 2013 2011 2012 2013 800 0 0 0 82M 706M 95% of Pharmacies Adopted E-Prescribing 600 The Surescripts network routed more Surescripts exchanged nearly 700 mil­ In 2013, Surescripts saw a 31% than one billion e-prescriptions in lion Medication History transactions in increase in the number of e-prescrip­ 58M Independent Chain 2013, representing 58% of all eligible 2013, up from nearly 400 million in tions routed from mail-order pharma­ Pharmacies 474M Pharmacies 400 prescriptions. This shows a 32% 2011. cies. The volume of e-prescriptions 79% 85% 88% 98% 1200 increase in volume over 2012 and 1.04 routed from mail-order pharmacies has almost double the total in 2011. BILLION +32% increased significantly in the past five 200 years, from just below 4 million in 2009 1000 2011 2012 2013 2011–2013 106M to more than 63 million in 2013. 932M 2011 2012 2013 Independent pharmacies increased adoption of Chain pharmacies remained constant at 0 800 82M e-prescribing by 11% since 2011. 98% adoption during the same period. 1 Based on a total count of 522,000 office-based physicians in the U.S. per SK&A data. Surescripts’706M count of active physicians represents those ambulatory-care physicians who used electronic 600 prescription routing services within the last 30 days of 2013. For the calculation of active office-based physicians in 2013, Surescripts made a 15% adjustment to remove acute physicians that are e-prescribing. 2 Electronic prescriptions of controlled substances are not included. 58M 474M 400 2 3 200 2011 2012 2013 0 79% 85% 88% 2011 2012 2013 www.surescripts.com TRANSFORMING HEALTH INFORMATION EXCHANGE 2013 National Progress Report and Safe-Rx Rankings 4,451 Primary 3, 4, 5 36 Hospitals Care Physicians12 • 817,205 ER Visits6 • 6.3 Million Patient Visits13 7 14 * • 5,797 Beds • 1 Million Referrals A Community View 8 • 13 EHRs • 58 EHRs8 In a typical metropolitan area with a population of 2 million, such as Cleveland, Ohio or Kansas City, Missouri, a web of providers and payers navigates this complex system to provide quality care to an increasingly informed and digitally connected patient. The complexity of the health system multiplies with the added communications needs among nursing homes, retail clinics, and long-term care facilities or when a patient needs care POPULATION: 2 MILLION while traveling outside their local community. Data is the life blood of healthcare, but the benefits of improving patient MESSAGES: 68 MILLION care, increasing efficiency and decreasing costs, cannot be realized if health information exists in isolation. Health information technology offers significant promise. CONNECTIONS: 6,838 The ability to share clinical information, quickly and securely, will transform the healthcare system. The electronic exchange of health information can help improve quality and control costs, but this simple idea is a difficult task given the complexity of the U.S. healthcare system. Surescripts has the infrastructure, data network, provider and supplier directories, and experience in 9 15 developing standards to 400 Pharmacies 784 Ambulatory Labs ensure that the healthcare 10 system is connected • 12.7 Million Prescriptions • 8.9 Million Ambulatory Lab and interoperable. • 16 Software Systems11 Tests 14 3 Surescripts analysis of American Hospital Association data and US Census Live Tracker Data. 10 Surescripts analysis of ‘Total Number of Retail Prescription Drugs Filled at Pharmacies.’ Kaiser Family Foundation. Available at: http://kff.org/other/state-indicator/total-retail-rx-drugs/ 4 American Hospital Association. Fast Facts on US Hospitals. Available at http://www.aha.org/research/rc/stat-studies/fast-facts.shtml 11 Surescripts estimate. 5 Source: https://www.census.gov/popclock/ Accessed 3/10/2014 at 11:12am et. 12 Surescripts analysis of SK&A data. 6 Surescripts analysis of NHAMCS data: National Hospital Ambulatory Medical Care Survey: 2010 Emergency